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Pilot Implementation Of The Vascular Surgery Entrustable Professional Activities
M Libby Weaver, MD
1,
Thomas Serena, DO1, Ting Sun, PhD
1, Kristyn Mannoia, MD
2, Raghu Motaganahalli, MD
3, Yana Etkin, MD
4, Michael C. Soult, MD
5, Brigitte K. Smith, MD, MHPE
6.
1University of Utah, Salt Lake City, UT, USA,
2Loma Linda University, Loma Linda, CA, USA,
3Indiana University, Indianapolis, IN, USA,
4Northwell Health, New York City, NY, USA,
5Loyola University Medical Center, Chicago, IL, USA,
6University of Wisconsin, Madison, WI, USA.
OBJECTIVES: Entrustable Professional Activities (EPAs) have been embraced by the medical education community as a framework to guide competency-based education systems. The Vascular Surgery Board and Association for Program Directors in Vascular Surgery collaborated on the development of 15 vascular surgery EPAs, covering the core clinical activities of a vascular surgeon. We sought to explore engagement and perceptions on feasibility and utility of EPA assessment implementation for participants in a national, multi-institutional pilot.
METHODS: Vascular surgery integrated residency and fellowship programs were recruited to participate. Faculty assessment and trainee self-assessment of 15 vascular surgery EPAs were rated on a 4-point entrustment scale: 1=limited participation, 2=direct supervision, 3=indirect supervision, and 4=practice-ready, with accompanying behavioral anchors describing the actions expected of a learner at each level. Following an introductory webinar, the American Board of Surgery EPA Application assessment tool (delivered via SIMPL) was provided to all participating programs. Surveys evaluating the perceived feasibility and utility of the EPAs were developed for pilot participants. The surveys were distributed via email in June, 2024 and responses were collected using REDCap. For Likert-scale items, descriptive statistics were calculated. For open-ended responses, a thematic analysis was conducted to explore perceptions of respondents.
RESULTS: Twenty-six institutions (23 fellowship, and 20 residency programs) participated in the pilot. Trainee entrustment was assessed during a total of 1,736 unique clinical encounters, totaling 2,823 EPA assessments completed by faculty and trainees. Post-pilot surveys were completed by 89 pilot participants, including 22 program directors (RR 73%), 13 program managers (RR 43%), 26 trainees, and 28 faculty. Regarding ease of integration of EPA assessments into peri-operative workflow, 92% of trainees and 96% of faculty had neutral or positive responses. 92% of trainees felt EPA assessment data helped them to identify areas for improvement. 96% of faculty felt the behavioral anchors helped them to identify areas on which to provide feedback.
CONCLUSIONS: This study demonstrates the feasibility and utility of EPA assessment implementation at a subset of vascular surgery training programs. Integration into usual clinical workflow was viewed as easy by both faculty and trainees. Furthermore, trainees felt the assessments were helpful to their learning, and faculty felt the assessment anchors helped them give meaningful feedback. These findings support an overall positive reception to EPA assessments in vascular surgery.
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